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Minimally cardiac surgery

Qiang Wang, Jia-Xin Ye, Min Ge, Dong-Jin Wang
This study reviews our results and experience with cardiothoracic surgery via RVIAT over the past 15 years. This retrospective overview summarises our results, describing the early and late clinical outcomes of 1,126 patients, including 370 ASD closures, 488 VSD closures and 268 valve surgeries, at a single center between October 2001 and December 2015. The mean follow-up time was 52 ± 35 months (range 8-120 months). The mean incision length was 6 ± 2.22 cm (range 3.9-8.9 cm). No patient required conversion to median sternotomy...
March 12, 2018: Scientific Reports
Joshua L Chan, Justin G Miller, Mandy Murphy, Ann Greenberg, Peggy Iraola, Keith A Horvath
BACKGROUND: Prolonged intubation following cardiac surgery is associated with significant morbidity. A fast-track extubation protocol primarily driven by bedside providers was instituted for all postoperative cardiac surgery patients to facilitate safe and expeditious extubation. METHODS: A retrospective review of 1581 cardiac surgery patients over an 8-year period was performed. Prior to 2011, non-protocolized standard perioperative management was utilized (n=807)...
March 9, 2018: Annals of Thoracic Surgery
Robert M Van Haren, Reza J Mehran, Arlene M Correa, Mara B Antonoff, Carla M Baker, Ta Charra Woodard, Wayne L Hofstetter, Gabriel E Mena, Jack A Roth, Boris Sepesi, Stephen G Swisher, Ara A Vaporciyan, Garrett L Walsh, David C Rice
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways aim to improve postoperative recovery through evidence-based practices including early ambulation, multimodal opioid-sparing analgesia, and reduction of surgical stress. The purpose of this study was to evaluate outcomes following implementation of ERAS in patients undergoing resection for pulmonary malignancy. METHODS: A retrospective review compared outcomes for patients undergoing pulmonary resection for primary lung cancer...
March 9, 2018: Annals of Thoracic Surgery
Kun Hua, Yang Zhao, Ran Dong, Taoshuai Liu
On Authors request: "Wrong total number of cases selected in the article, wrong number of cases in the minimally invasive surgery, and there are errors in the hospital complications" Reference: Minimally Invasive Cardiac Surgery in China: Multi-Center Experience Kun Hua, Yang Zhao, Ran Dong, Taoshuai Liu Med Sci Monit 2018;24: 421-426 10.12659/MSM.905408.
March 12, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Blanca Meana, Daniel Hernandez-Vaquero, Jacobo Silva
No abstract text is available yet for this article.
March 5, 2018: Archivos de Bronconeumología
Roberta Rossini, Giuseppe Tarantini, Giuseppe Musumeci, Giulia Masiero, Emanuele Barbato, Paolo Calabrò, Davide Capodanno, Sergio Leonardi, Maddalena Lettino, Ugo Limbruno, Alberto Menozzi, U O Alfredo Marchese, Francesco Saia, Marco Valgimigli, Walter Ageno, Anna Falanga, Antonio Corcione, Alessandro Locatelli, Marco Montorsi, Diego Piazza, Andrea Stella, Antonio Bozzani, Alessandro Parolari, Roberto Carone, Dominick J Angiolillo
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided...
March 12, 2018: JACC. Cardiovascular Interventions
Kenji Sakai, Tomohiro Mizuno, Taiju Watanabe, Eiki Nagaoka, Keiji Oi, Masafumi Yashima, Tsuyoshi Hachimaru, Hidehito Kuroki, Tatsuki Fujiwara, Masashi Takeshita, Minoru Tanabe, Hirokuni Arai
BACKGROUND: The right gastroepiploic artery (GEA) is utilized as an excellent in-situ arterial graft conduit to right coronary artery territory for coronary artery bypass grafting (CABG). However, there remains great concerns regarding the management of patients with a patent in-situ GEA during abdominal surgery following CABG. METHODS: From 1995 to 2016, GEA was used for CABG in 278 patients at our institution. Of the patients, 14 abdominal surgeries were performed for subsequent abdominal diseases in 11 patients with a patent in-situ GEA for CABG...
March 3, 2018: Annals of Thoracic Surgery
Ioannis D Gkegkes, Evelyn Eleni Minis, Christos Iavazzo
BACKGROUND: The role of analgesia is crucial in the management of postoperative pain. Different combinations of oral analgesics have been proposed in the past. The oxycodone/naloxone (OXN) combination is a recent addition and is being used by different surgical specialties. The aim of our study was to clarify the possible role, advantages, and disadvantages of OXN in the pain management of surgical patients. METHOD: The authors retrieved the included studies after performing a systematic search in PubMed and Scopus...
January 2018: Journal of Opioid Management
Habib Khan, Christopher Hadjittofi, Mohsin Uzzaman, Kareem Salhiyyah, Sheena Garg, Salman Butt, Haleema Aya, Sanjay Chaubey
OBJECTIVES: Minimally invasive cardiac valve surgery is safe, effective and increasingly popular. It is performed worldwide with the use of either external aortic clamping or endoaortic balloon occlusion. METHODS: We conducted a literature search using MEDLINE, EMBASE, Scopus and Web of Science. Primary outcomes included aortic dissection, conversion to sternotomy, mortality, stroke and cross-clamp time. Secondary outcomes included atrial fibrillation, acute kidney injury, reoperation for bleeding, cardiopulmonary bypass times, myocardial infarction, use of intra-aortic balloon pump and length of hospital stay...
February 28, 2018: Interactive Cardiovascular and Thoracic Surgery
Blake S Raggio, Blair M Barton, Emad Kandil, Paul L Friedlander
Importance: No evidence exists to direct the management of preoperative aspirin (acetylsalicylic acid) use in patients undergoing thyroid surgery. Nevertheless, a considerable number of patients interrupt receiving aspirin therapy during the preoperative period to minimize bleeding complications despite the increased risk of experiencing major adverse cardiac events. Objective: To determine whether aspirin therapy continued preoperatively increases bleeding complications in patients undergoing thyroid surgery...
March 1, 2018: JAMA Otolaryngology—Head & Neck Surgery
Louise A Kenny, Fabrizio DeRita, Mohamed Nassar, John Dark, Louise Coats, Asif Hasan
The single ventricle patient population comprises the most complex cohort presenting to the cardiac transplant team, in terms of demographics, anatomic substrate, and unique physiology. It is also the most rapidly growing diagnostic group presenting for heart transplantation. In this manuscript, we aim to describe the changing landscape of transplantation in single ventricle conditions through reflection on our own institution's practice and experience, alongside contemporary literature review. Single ventricle patients are heterogeneous in terms of age, anatomic diagnosis and physiology according to surgical stage of repair...
January 2018: Annals of Cardiothoracic Surgery
Jawad Salman, Felix Fleißner, Jamshid Naqizadah, Murat Avsar, Malakh Shrestha, Gregor Warnecke, Issam Ismail, Stefan Rümke, Serghei Cebotari, Axel Haverich, Igor Tudorache
BACKGROUND:  Minimally invasive mitral valve surgery (MIMVS) is superior to "classical" mitral valve surgery via a sternotomy regarding wound healing and postoperative pain. It is however a more challenging procedure. Patients' preference is leading clearly toward minimally invasive approaches, and surgeons are driven by upcoming new technologies in interventional procedures such as the MitraClip. Especially in re-do cases, the access via right mini-thoracotomy, as previously non-operated situs, is a possible advantage over a re-sternotomy...
February 28, 2018: Thoracic and Cardiovascular Surgeon
Benedikt Mayr, Christian Firschke, Magdalena Erlebach, Sabine Bleiziffer, Markus Krane, Michael Joner, Ulf Herold, Christian Nöbauer, Rüdiger Lange, Marcus-André Deutsch
OBJECTIVES: Simultaneous surgical off-pump coronary revascularization and transcatheter aortic valve implantation (TAVI) as a hybrid procedure may be a therapeutic option for patients with a TAVI indication who are not suitable for percutaneous coronary intervention and for patients who have an indication for combined surgical aortic valve implantation and coronary artery bypass grafting but present with a porcelain aorta. Early outcomes of these patients are analysed in this study. METHODS: From February 2011 to April 2017, hybrid TAVI/off-pump coronary artery bypass (OPCAB) was performed in 12 (60%) patients, hybrid TAVI/minimally invasive direct coronary artery bypass in 6 (30%) patients and staged TAVI/OPCAB in 2 (10%) patients...
February 26, 2018: Interactive Cardiovascular and Thoracic Surgery
İsmail Oral Hastaoglu, Hamdi Tokoz, Ayca Ozgen, Fuat Bilgen
BACKGROUND: While minimally invasive procedures are being used in cardiac surgery, experience with minimally invasive proximal aortic surgery has been limited to certain centers. METHODS: Between January 2010 and March 2015, 54 patients with an upper "J" hemi-sternotomy and 75 patients with a conventional sternotomy due to proximal aortic pathology were included in this study. Forty-five patients from the "J" hemi-sternotomy group were matched with 45 patients from the conventional sternotomy group with respect to age, sex, ejection fraction, diabetes, hypertension, smoking history and operative type...
January 5, 2018: Heart Surgery Forum
Jan-Philipp Minol, Payam Akhyari, Udo Boeken, Alexander Albert, Philipp Rellecke, Vanessa Dimitrova, Stephan Urs Sixt, Hiroyuki Kamiya, Artur Lichtenberg
Background: Cardiac redo surgery, especially after a full sternotomy, is considered a high-risk procedure. Minimally invasive mitral valve surgery (MIMVS) is a potential therapeutic approach. However, current developments in interventional cardiology necessitate additional discussion regarding the therapy of choice in high-risk patients. In this context, it is necessary to clarify the perioperative and postoperative risks induced by the factor previous sternotomy in the setting of MIMVS...
2018: Frontiers in Surgery
Kelly J Oliver, Michael J Casas, Peter L Judd, Jennifer L Russell
Objective: Children with cardiac defects should have good oral health, particularly prior to cardiac surgery to minimize risks of infective endocarditis. The aim of the study was to examine the oral health assessment practices of North American cardiologists. Methods: Online surveys were e-mailed to 1409 cardiologists. Cardiologists without paediatric patients or practicing in centres without cardiac surgical care were excluded. Surveys addressed oral health assessment practices for paediatric cardiac patients, and perceptions of the impact of oral health on cardiac care...
September 2017: Paediatrics & Child Health
Johan van der Merwe, Frank Van Praet, Bernard Stockman, Ivan Degrieck, Yvette Vermeulen, Filip Casselman
OBJECTIVES: This study reports the factors that contribute to sternotomy conversions (SCs) and adverse intraoperative events in minimally invasive aortic valve surgery (MI-AVS) and minimally invasive Endoscopic Port Access™ atrioventricular valve surgery (MI-PAS). METHODS: In total, 3780 consecutive patients with either aortic valve disease or atrioventricular valve disease underwent minimally invasive valve surgery (MIVS) at our institution between 1 February 1997 and 31 March 2016...
February 14, 2018: European Journal of Cardio-thoracic Surgery
Shintaro Nemoto, Hayato Konishi, Ryo Shimada, Tatsuya Suzuki, Takahiro Katsumata, Hideaki Yamada, Jun Sakurai, Yohei Sakamoto, Kazuteru Kohno, Atsuko Onishi, Masaya Ito
OBJECTIVES: Materials used in paediatric cardiac surgery have drawbacks of deterioration, calcification and pseudointimal proliferation resulting in haemodynamic disturbance. The aim of this study was to investigate whether these drawbacks can be overcome by in situ tissue regeneration using a newly developed synthetic hybrid fabric (SHF). METHODS: The SHF is an expandable, warp-knitted fabric composed of a combination of biodegradable [poly-l-lactic acid (PLLA)] and non-biodegradable (polyethylene terephthalate) yarns...
February 14, 2018: European Journal of Cardio-thoracic Surgery
Marco Moscarelli, Nora Terrasini, Anna Nunziata, Prakash Punjabi, Gianni Angelini, Marco Solinas, Alba Buselli, Paolo Del Sarto, Dorela Haxhiademi
OBJECTIVE: Minimally invasive mitral valve repair may be associated with prolonged cardioplegic arrest times and ischemic reperfusion injury. Intravenous (propofol) and volatile (sevoflurane) anesthesia are used routinely during cardiac surgery and are thought to provide cardioprotection; however, the individual contribution of each regimen to cardioprotection is unknown. Therefore, the authors sought to compare the cardioprotective effects of propofol and sevoflurane anesthesia in patients undergoing minimally invasive mitral valve repair...
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Emiliano A Rodríguez-Caulo, Ana Guijarro-Contreras, Juan Otero-Forero, María José Mataró, Gemma Sánchez-Espín, Arantza Guzón, Carlos Porras, Miguel Such, Antonio Ordóñez, José María Melero-Tejedor, Manuel Jiménez-Navarro
BACKGROUND: During the last decade, the use of ministernotomy in cardiac surgery has increased. Quality of life and patient satisfaction after ministernotomy have never been compared to conventional full sternotomy in randomised trials. The aim of the study is to determine if this minimally invasive approach improves quality of life, satisfaction and clinical morbimortality outcomes. METHODS/DESIGN: The QUALITY-AVR trial is a single-blind, single-centre, independent, and pragmatic randomised clinical trial comparing ministernotomy ("J" shaped upper hemisternotomy toward right 4th intercostal space) to full sternotomy in patients with isolated severe aortic stenosis scheduled for elective aortic valve replacement...
February 17, 2018: Trials
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